TACHYCARDIA Edited by Takumi Yamada Tachycardia Edited by Takumi Yamada Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Molly Kaliman Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Tachycardia, Edited by Takumi Yamada p. cm. ISBN 978-953-51-0413-1 Contents Preface IX Chapter 1 Accurate Detection of Paediatric Ventricular Tachycardia in AED 1 U. Irusta, E. Aramendi, J. Ruiz and S. Ruiz de Gauna Chapter 2 Surgical Maze Procedures for Atrial Arrhythmias in Univentricular Hearts, from Maze History to Conversion–Fontan 25 Charles Kik and Ad J.J.C. Bogers Chapter 3 Definition, Diagnosis and Treatment of Tachycardia 41 Anand Deshmukh Chapter 4 Ryanodine Receptor Channelopathies: The New Kid in the Arrhythmia Neighborhood 65 María Fernández-Velasco, Ana María Gómez, Jean-Pierre Benitah and Patricia Neco Chapter 5 The Effects of Lidocaine on Reperfusion Ventricular Fibrillation During Coronary Artery – Bypass Graft Surgery 89 Ahmet Mahli and Demet Coskun Chapter 6 Tachycardia as “Shadow Play” 97 Andrey Moskalenko Chapter 7 Metabolic Modulators to Treat Cardiac Arrhythmias Induced by Ischemia and Reperfusion 123 Moslem Najafi and Tahereh Eteraf-Oskouei Chapter 8 Mechanisms of Ca 2+ –Triggered Arrhythmias 159 Simon Sedej and Burkert Pieske VI Contents Chapter 9 Heart Rate Variability: An Index of the Brain–Heart Interaction 187 Ingrid Tonhajzerova, Igor Ondrejka, Zuzana Turianikova, Kamil Javorka, Andrea Calkovska and Michal Javorka Preface Tachycardia is defined as a faster heart rhythm than normal sinus rhythm (with a rate of greater than 100 beats per minute in humans). Tachycardias can occur from different clinical backgrounds including congenital or acquired heart diseases, electrophysiological mechanisms and origins. The diagnosis of tachycardias is made by surface electrocardiograms and electrophysiological testing. The management and treatment of tachycardias including pharmacological and non-pharmacological approaches are determined based on these factors. These concerns have been studied and the details have been increasingly recognized. In this book, internationally renowned authors have contributed chapters detailing these concerns of tachycardias from basic and clinical points of view and the chapters will lead to a further understanding and improvement in the clinical outcomes of tachycardias. Dr. Takumi Yamada Distinguished Professor of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, USA [...]... (Sirbaugh et al., 1999) The most common cause of cardiac arrest in children is respiratory arrest, although the incidence of cardiac arrest caused by ventricular arrhythmias increases with age (Appleton et al., 1995; Atkins et al., 2 2 Tachycardia Will-be-set -by- IN-TECH 1998) Initially two independent studies provided evidence for the use of AED in paediatric patients (Atkinson et al., 2003; Cecchin et... for which the benefits of defibrillation are uncertain 4 4 Tachycardia Will-be-set -by- IN-TECH An adult and a paediatric database were compiled using ECG records collected from in- and out-of-hospital sources Three cardiologists assigned a rhythm type and a shock/no-shock recommendation to each record For potentially shockable rhythms, the criteria by which to determine the shock/no-shock recommendation... the FFT (Barro et al., 1989) The PSD 5 VF records were excluded from the analysis because VF is an irregular ventricular rhythm characterized by the absence of QRS complexes and a well-defined heart rate 9 9 Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED 0.024 0.015 0.016 0.010 0.008 0.005 0 100 150 200 250 HR (bpm) 300 0... large because of the rapid variations in the QRS complexes, and the power 12 12 Tachycardia Will-be-set -by- IN-TECH 7 16 6 12 5 fd fd 8 4 3 4 2 2 3 5 4 6 7 fc (a) VT The dominant frequency accurately represents the ventricular rate 1 2 3 fc 4 5 (b) SVT The dominant frequency frequently appears in higher harmonics as shown by lines of increasing slope Fig 5 Relation between f d computed in the frequency... (-0.02-0.38) (1.00-1.00) (0.04-0.23) (1.00-1.00) Table 4 Mean value (mean ± standard deviation) of f c and f d by rhythm type and population group The correlation coefficient r ( f d , f c ) between these variables and its corresponding 95 % CI are also reported 14 14 Tachycardia Will-be-set -by- IN-TECH On average, SVT presents up to six significant harmonics6 , although some adult SVT have over 10 significant... discriminate supraventricular from ventricular tachycardia in automated external defibrillators valid for adult and paediatric patients., Resuscitation 80(11): 1229–1233 Irusta, U., Ruiz, J., Aramendi, E & de Gauna, S R (2008) Amplitude, frequency and complexity features in paediatric and adult ventricular fibrillation., Resuscitation 77: S53–S53 24 24 Tachycardia Will-be-set -by- IN-TECH Jacobs, I., Nadkarni, V.,... systemic and pulmonary circulation without a subpulmonary ventricle for the palliation of patients with a univentricular heart was first described by Fontan and Baudet (Fontan & Baudet, 1971) Successful application of this complete right heart bypass was soon confirmed by others (Kreutzer et al., 1973) The fact that the circulation could be maintained in the absence of the pulmonary ventricle was one of the... accurate detection of VT (Aramendi et al., 2010; Atkins et al., 2008; Irusta & Ruiz, 2009) 3 The MIT-BIH arrhythmia, the AHA and Creighton University ventricular tachyarrhythmia databases 6 6 Tachycardia Will-be-set -by- IN-TECH Several records from the SVT/VT database were the most difficult to agree on for the cardiologists who classified the records in our databases Based on a single-lead recording of a... with disagreements in diagnosis (heart rate 210 bpm) 0.70 0 −1.50 0 2 4 6 8 10 (d) Paediatric VT with disagreements in diagnosis (heart rate 255 bpm) Fig 1 Paediatric supraventricular tachycardia (SVT) and ventricular tachycardia( VT) records that required a forced consensus between cardiologists for the rhythm classification For an accurate SVT/VT diagnosis, attention should be paid to the differences... increases and contributes more significantly to overall cardiac output The duration of the QRS complex is shorter in children than in adults because of the smaller Accurate Detection Ventricular TachycardiaVentricular Tachycardia in AED Accurate Detection of Paediatric of Paediatric in AED 7 7 cardiac muscle mass in children (Chan et al., 2008), while the QT interval is similar in children and adults The . TACHYCARDIA Edited by Takumi Yamada Tachycardia Edited by Takumi Yamada Published by InTech Janeza Trdine. hard copies can be obtained from orders@intechopen.com Tachycardia, Edited by Takumi Yamada p. cm. ISBN 978-953-51-0413-1 Contents